Flagler Hospital's rural designation does not meet state rules

Change would make Flagler eligible for $3M

TALLAHASSEE — Language in the state’s newly minted $70 billion spending plan would give Flagler Hospital in St. Augustine a “rural hospital” designation, despite the fact that the hospital does not meet the state requirements to be a rural hospital.

The same move, which would net the facility more than $3 million, was vetoed by Gov. Rick Scott last year.

The hospital meets the federal definition of a rural hospital but does not meet Florida’s definition, which specifies that a facility have 100 or fewer beds and be located in a county with less than 100 people per square mile.

Flagler is a 335-bed facility, and St. Johns County has 922 people per square mile, according to the Agency for Health Care Administration. Area rural hospitals include the 54-bed Baptist Medical Center in Fernandina Beach, and the 68-bed Baker Community Hospital in Macclenny.

Gina McLean, a hospital spokeswoman, said the intent was not to “compare statistics,” but give the funding category to federally qualified hospitals that “share similar challenges.”

“Flagler Hospital meets the spirit of a rural designation, which provides consideration to hospitals that truly serve as a health-care safety net for their community and offer access to hospital-based care in close proximity in an area where it does not otherwise exist,” McLean said.

House budget chief Denise Grimsley, R–Sebring, said she thought Flagler was “just short of the state requirement” when asked Monday about why budget writers gave Flagler the rural definition.

The rural designation would be given through next year’s budget only. Legally, the hospital would still be a non-rural hospital, and would revert back to that status in fiscal year 2013. The one-year switch would net the hospital $1.4 million in state revenue, and an additional $2 million in federal matching fund.

State Sen. John Thrasher, R–St. Augustine, sat on a panel of Senate budget negotiators, and said he wants to try to get the hospital permanent rural status moving forward.

“Once we get our nose under the tent, I plan on trying to come back next year and try to, at some point, get it in on a permanent basis,” he said Monday after negotiations concluded.

On Tuesday, he said he sought the rural designation for Flagler because it is the only the only hospital in St. Johns County.

The Legislature’s proposed budget slashes $303 million from Medicaid reimbursements to hospitals. They included an exemption for rural and children’s hospitals, but because Flagler is still legally a non-rural hospital, the facility will be subject to the cuts.